| Julastene Dyer-moore, DDS | |
|
199 Highway 50, Pecos, NM 87552 | |
| (505) 757-6666 | |
| Not Available |
| Full Name | Julastene Dyer-moore |
|---|---|
| Gender | Female |
| Speciality | Dentist - General Practice |
| Location | 199 Highway 50, Pecos, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750671954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DEN10751 (Colorado) | Secondary |
| 122300000X | Dentist | DD4171 (New Mexico) | Secondary |
| 1223G0001X | Dentist - General Practice | DD4171 (New Mexico) | Primary |
| Entity Name | Presbyterian Medical Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871505032 PECOS PAC ID: 2062324684 Enrollment ID: O20031103000414 |
| Mailing Address | Practice Location Address |
|---|---|
| Julastene Dyer-moore, DDS Po Box 710, Pecos, NM 87552-0710 Ph: (505) 757-6666 | Julastene Dyer-moore, DDS 199 Highway 50, Pecos, NM 87552 Ph: (505) 757-6666 |
Claudia Quan, DDS Dentist Medicare: Medicare Enrolled Practice Location: 199 Highway 50, Pecos, NM 87552 Phone: 505-757-6482 | |
Daniel Keith Evans, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 199 Hwy 50, Pecos, NM 87552 Phone: 505-757-6666 Fax: 505-757-2700 | |
Richard C Peters, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 199 Hwy 50, Pecos, NM 87552 Phone: 505-757-6666 Fax: 505-757-2700 |